TY - JOUR
T1 - Management of women who test positive for high-risk types of human papillomavirus: the HART study
AU - Cuzick, J
AU - Szarewski, A
AU - Cubie, H
AU - Hulman, G
AU - Kitchener, H
AU - Luesley, David
AU - McGoogan, E
AU - Menon, U
AU - Terry, G
AU - Edwards, R
PY - 2003/12/6
Y1 - 2003/12/6
N2 - BACKGROUND: Certain types of human papillomavirus (HPV) are the primary cause of almost all cervical cancers. HPV testing of cervical smears is more sensitive but less specific than cytology for detecting high-grade cervical intraepithelial neoplasia (CIN2+). HPV testing as a primary screening approach requires efficient management of HPV-positive women with negative or borderline cytology. We aimed to compare the detection rate and positive predictive values of HPV assay with cytology and to determine the best management strategy for HPV-positive women. METHODS: We did a multicentre screening study of 11085 women aged 30-60 years. Women with borderline cytology and women positive for high-risk HPV with negative cytology were randomised to immediate colposcopy or to surveillance by repeat HPV testing, cytology, and colposcopy at 12 months. FINDINGS: HPV testing was more sensitive than borderline or worse cytology (97.1% vs 76.6%, p=0.002) but less specific (93.3% vs 95.8%, p
AB - BACKGROUND: Certain types of human papillomavirus (HPV) are the primary cause of almost all cervical cancers. HPV testing of cervical smears is more sensitive but less specific than cytology for detecting high-grade cervical intraepithelial neoplasia (CIN2+). HPV testing as a primary screening approach requires efficient management of HPV-positive women with negative or borderline cytology. We aimed to compare the detection rate and positive predictive values of HPV assay with cytology and to determine the best management strategy for HPV-positive women. METHODS: We did a multicentre screening study of 11085 women aged 30-60 years. Women with borderline cytology and women positive for high-risk HPV with negative cytology were randomised to immediate colposcopy or to surveillance by repeat HPV testing, cytology, and colposcopy at 12 months. FINDINGS: HPV testing was more sensitive than borderline or worse cytology (97.1% vs 76.6%, p=0.002) but less specific (93.3% vs 95.8%, p
UR - http://www.scopus.com/inward/record.url?scp=10744221527&partnerID=8YFLogxK
U2 - 10.1016/S0140-6736(03)14955-0
DO - 10.1016/S0140-6736(03)14955-0
M3 - Article
C2 - 14667741
SN - 1474-547X
VL - 362
SP - 1871
EP - 1876
JO - Lancet
JF - Lancet
IS - 9399
ER -
